Provider Demographics
NPI:1750365318
Name:MARSHAK, DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:MARSHAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 W 115TH ST # 350
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7722
Mailing Address - Country:US
Mailing Address - Phone:718-881-4100
Mailing Address - Fax:718-881-4101
Practice Address - Street 1:729 PELHAM PKWY N
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-9506
Practice Address - Country:US
Practice Address - Phone:718-881-4100
Practice Address - Fax:718-881-4101
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200019-1202C00000X, 207L00000X, 207LH0002X, 208D00000X, 208VP0000X, 208VP0014X, 207LP2900X
NJ25MA08033900207L00000X, 207LH0002X, 207LP2900X, 208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LH0002XAllopathic & Osteopathic PhysiciansAnesthesiologyHospice and Palliative Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01769502Medicaid
NYDM71A581Medicare ID - Type Unspecified
NY01769502Medicaid